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Brain injuries
Background Brain injuries happen in war, in sport, in work and in life. Insights * The War in Iraq has brought back one of the worst afflictions of World War I trench warfare: shell shock. The brain of a soldier exposed to a roadside bomb is shocked, truly. Links Media * A Shock Wave of Brain Injuries washingtonpost.com, By Ronald Glasser, April 8, 2007, 'We can save you. But you might not be what you were.' Neurosurgeon, Combat Support Hospital, Balad, Iraq Details * About 1,800 U.S. troops, according to the Department of Veterans Affairs, are suffering from traumatic brain injuries (TBIs) caused by penetrating wounds. But neurologists worry that hundreds of thousands more -- at least 30 percent of the troops who've engaged in active combat for four months or longer in Iraq and Afghanistan -- are at risk of potentially disabling neurological disorders from the blast waves of IEDs and mortars, all without suffering a scratch. * The U.S. military is treating more head injuries than chest or abdominal wounds, and it is ill-equipped to do so. According to a July 2005 estimate from Walter Reed Army Medical Center, two-thirds of all soldiers wounded in Iraq who don't immediately return to duty have traumatic brain injuries. * The detonation of any powerful explosive generates a blast wave of high pressure that spreads out at 1,600 feet per second from the point of explosion and travels hundreds of yards. The lethal blast wave is a two-part assault that rattles the brain against the skull. The initial shock wave of very high pressure is followed closely by the "secondary wind": a huge volume of displaced air flooding back into the area, again under high pressure. No helmet or armor can defend against such a massive wave front. ** It is these sudden and extreme differences in pressures -- routinely 1,000 times greater than atmospheric pressure -- that lead to significant neurological injury. Blast waves cause severe concussions, resulting in loss of consciousness and obvious neurological deficits such as blindness, deafness and mental retardation. Blast waves causing TBIs can leave a 19-year-old private who could easily run a six-minute mile unable to stand or even to think. * Blast-related brain injuries differ from other severe head traumas. The complexity of treating "closed-head" injuries is taxing an already overburdened military health-care system. * ABC News anchor, Bob Woodruff, suffered severe brain injuries from an IED blast in Baghdad in 2006. "TBIs from Iraq are different," said P. Steven Macedo, a neurologist and former doctor at the Veterans Administration. Concussions from motorcycle accidents injure the brain by stretching or tearing it, he noted. But in Iraq, something else is going on. "When the sound wave moves through the brain, it seems to cause little gas bubbles to form," he said. "When they pop, it leaves a cavity. So you are littering people's brains with these little holes." * Soldiers walking away from IED blasts have discovered that they often suffer from memory loss, short attention spans, muddled reasoning, headaches, confusion, anxiety, depression and irritability. * IEDs = improvised explosive devices. * Brain injuries-planks-Rauterkus More * U.S. troops no longer die from the kind of injuries that killed many thousands in Vietnam. ** During the Vietnam War, according to the VA, the ratio was 2.6 to 1. ** In Iraq and Afghanistan, the ratio of wounded service members to fatalities is 16 to 1, if the definition of "wounded" is anyone evacuated from a combat zone. This is the first war in which troops are very unlikely to die if they're still alive when a medic arrives. ** Today's body armor is dramatically effective in preventing fatal wounds of the chest and upper abdomen. There is not an orthopedic or general surgeon in Iraq or Afghanistan who hasn't been astonished the first time a trooper with two missing limbs and a traumatic brain injury is carried off in a chopper and the surgeon removing the armor cannot find a scratch from the chin to the groin. * Most of the families of our wounded interviewed months, if not years, after the injury say the same thing: "Someone should have told us that with these closed-head injuries, things would not really get all that much better." * The War in Iraq is not a war of death for U.S. troops nearly so much as it is a war of disabilities. The symbol of this battle is not the cemetery but the orthopedic ward and the neurosurgical unit. T * Troops come home alive but missing arms and legs, many unable to see or hear or remember who they were before being hit by a roadside bomb. category:wellness